Environmental Education Registration

Skyland Ranch Environmental Education Reservation Request
Contact Name*

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.
School Name*
Address (to mail items if needed)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purpose of the form:*

We need pricing information to make a decisionWe need more information and/or have questionsWe are ready to sign-up but also have questions or need pricing information before we commit; please complete the information below so we can better serve you.
Program
Which program interests you?*

Environmental Education: Climate ChangeCareer ExplorationOutdoor AdventureBe a Friend First (Anti-Bullying Program)Customized Program
Would you like to participate in pre and/or post lesson plans?*
Select your preferred date of program (if another school has selected a date it will not be available).*
Thank you for choosing a preferred date above. If this date is not available what are 2 additional dates you could consider. Please leave notes for our scheduler in this box.*
Attendees
Estimated Number of Students*
Estimated Number of Chaperones (plan to bring at least 1:25; no more than 1:10 unless discussed with scheduler)*
What grade are your student's in?*
If you have less than 50 students, do you agree that you may be combined with another group?

YesNo; we are willing to pay for 50 spots if needed
Information Needed
Will you bring your own First Aider and First Aid Kit?*

YesNo
If no; Skyland Ranch will provide an appropriate primary First Aider. We will need each student to complete a GSSGC permission slip that includes permission to treat a minor?*

I understand and agree we will work with our parents to ensure they are completed.
Funding Information

Most of our programs are highly subsidized to keep the costs low for schools and families. Our funders are requesting information on participants. Please check all that apply to your students.
Are you planning to request any of the following (see criteria in questions below for eligibility for current grant funding):*

We are funding in other ways (nothing additional needed)Full Grant Funding (covers bus and cost of program)Partial Grant Funding (cost of program)Bus help (reimbursement for the bus)Financial Assistance for specific studentsOther
Are you a Title 1 School*

YesNo
Is your school located in either Riverside or San Bernardino County?*

YesNo
Our funders and board are requesting information on all of our participants even if you are not requesting additional grant funding, because all of our programs are highly subsidized. They are interested in serving schools and classes who may otherwise not be able to participate in these types of opportunities.
Consider your attendees as a whole. Would at least 51% meet one or more of the following? If yes please check all that apply to your students:

Students who qualify for free or reduced lunchStudents who have special needs-physical disability, emotional or behavioral difficultyStudents who are from primarily Spanish speaking householdsStudents who qualify for WIC, IEHP, Medi-Cal or other low-income programStudents in Foster or Kin careStudents who are homeschooledStudents who are African American, Pacific Islander, Native American, Asian, LatinXOther
Would you be willing to fill out a brief questionnaire/survey within 2 weeks of your Environmental Education Day at Skyland Ranch (required for schools receiving additional grant funding beyond normal subsidizing that occurs with all our programs)?*

YesNo
Anything else we need to know?
Next Steps
Thank you for choosing Sklyand Ranch for your Environmental Education experience!

This form is a reservation request and dates are not guaranteed until the final paperwork is submitted.

You will receive and email with a link for the confirmation of your date and a Reservation Agreement within 9 business days.

If we have any questions or your first-choice date is not available, we will contact the person listed above.

If you have any questions, please contact programcoordinator@gssgc.org or 909-307-6555

We look forward to serving you and your students!

Thank you!

The Skyland Ranch Environmental Education Team
Should be Empty:

Skyland Ranch Environmental Education Reservation Request

Program

Attendees

Information Needed

Funding Information

Next Steps